19 November 2021

NHS Race and Health Observatory appoints sickle cell expert

The NHS Race and Health Observatory is pleased to announce the new appointment of a medical advisor to explore sickle cell inequalities in NHS healthcare delivery.

Dr Carl Reynolds, a consultant respiratory and general internal medicine physician at North Middlesex University Hospital NHS Trust, will join the Observatory from December 2021.

Predominantly affecting people with African or Caribbean heritage, sickle cell disease is characterised by unusually shaped red blood cells that are produced which can cause serious health issues across the body, sending organs into ‘crisis’ and causing extreme levels of pain which may need hospitalisation.

The new appointment will further support work on the Observatory’s priorities to tackle ethnic health inequalities through evidence-based recommendations for change. It also coincides with a new report out this week – ‘No one’s listening’, from the All-Party Parliamentary Group (APPG) on Sickle Cell and Thalassaemia and the Sickle Cell Society.

As a key priority, Dr Reynolds will review evidence that contrasts sickle cell care with other rare genetic diseases such as cystic fibrosis and examine how robust sickle cell care patient pathways can be provided by the NHS. This contribution will support research, insights and practical interventions to level-up geographical variation in sickle cell care across the country.

The work will also propose strategic policy recommendations for sustainable change including ensuring access to evidence based treatment options such as Crizanlizumab, a drug to prevent recurrent sickle cell crisis, which was approved by NICE and NHS England this month.

Dr Habib Naqvi, director of the NHS Race and Health Observatory, said:

“I am delighted that Carl is joining the Observatory at this pivotal time. Inequalities in healthcare experience and variability in treatment for people living with sickle cell, highlighted in the latest report from the Sickle Cell Society and All-Party Parliamentary Group, are unacceptable and need concerted focus.

“This report sadly exposed a worrying shortfall in adequate care and treatment for sickle cell patients, namely the late Evan Nathan Smith and others, who have not received the care that they so critically needed and have prematurely and tragically died.

“The NHS Race and Health Observatory is deeply concerned that patients with this condition reported being treated with disrespect, not being believed or listened to, and not being treated as a priority by healthcare professionals, even during cases where urgent medical care is required.

“We clearly know that the most vulnerable in society are often those who experience the cumulative impact of health inequalities.”

Carl Reynolds has provided clinical care to sickle cell patients as a medical doctor in A&E and held a number of operational and strategic leadership posts; he is the asthma lead and chief medical information officer at North Middlesex University Hospital and an honorary senior clinical lecturer at the National Heart and Lung Institute at Imperial College London.

Dr Carl Reynolds, said:

“I am looking forward to working with the NHS Race and Health Observatory and stakeholder partners across the healthcare system.

“Deaths from sickle cell in the UK are avoidable. Unacceptable sickle cell inequalities have persisted for too long and are at least in part attributable to structural racism.

“To date the NHS has failed in its duty to provide sickle cell patients with consistently high quality care; it has failed in its duty to learn from avoidable harm caused to sickle cell patients; it can and must urgently do better.”

The placement will build system-wide relationships with the Sickle Cell Society and across the health care system, with key stakeholders including NHS England and Improvement, Department of Health and Social Care, Health Education England, Office for Health Improvement and Disparities, National Institute for Health and Care Excellence and others, to support insight-driven recommendations for improving the sickle patient care pathway.

Carl was a national clinical fellow to Sir Liam Donaldson at the National Patient Safety Agency and to Health Education England, before obtaining an NIHR Academic Clinical Fellowship in respiratory medicine and a Wellcome Trust Clinical Research Training Fellowship studying occupational lung disease.

John James OBE, Chief Executive, Sickle Cell Society, said:

“The Sickle Cell Society welcomes the news that the NHS Race and Health Observatory have appointed a medical advisor, Dr Carl Reynolds, to explore sickle cell inequalities in the NHS, coinciding with the publication and recommendations from our recent inquiry report, No One’s Listening.

“The report (published jointly with the Sickle Cell and Thalassaemia All-Party Parliamentary Group) found a weight of evidence that suggests that the negative attitudes that sickle cell patients experience in general wards and Accident and Emergency, are often underpinned by racism.

We look forward to working with Dr Carl Reynolds, and hope that this appointment will be a positive step towards delivering our recommendations for a study into sickle cell care in relation to race and ethnicity, examining the impact of racist attitudes and the extent of inequalities.”